The Effects of Intravenous Lipid Emulsion Therapy in the Prevention of Depressive Effects of Propofol on Cardiovascular and Respiratory Systems: An Experimental Animal Study.

Fatih Doğanay,Serdar Abut,Özge Onur,Halil Alışkan,Rohat Ak,Engin Sümer

doi:10.3390/medicina55010001

Abstract

Background and objectives: Although there are several hypotheses about the mechanism of action, intravenous lipid emulsion (ILE) therapy has been shown to be effective in the treatment of toxicities due to local anaesthetics and many lipophilic drugs. In this study, we had hypothesized that ILE therapy might also be effective in preventing mortality and cardiorespiratory depressant effects due to propofol intoxication. Materials and methods: Twenty-eight Sprague-Dawley adult rats were randomly divided into four groups. Saline was administered to the subjects in the control group. The second group was administered propofol (PP group); the third group was administered ILE (ILE group), and the fourth group was administered propofol and ILE therapy together (ILE+PP group). Systolic blood pressure (SBP), diastolic blood pressure (DBP), respiratory rate (RR), heart rate (HR), and mortality were recorded at 10 time-points during a period of 60 min. A repeated measures linear mixed-effect model with unstructured covariance was used to compare the groups. Results: In the PP group; SBP, DBP, RR, and HR levels declined steadily; and all rats in this group died after the 60-min period. In the ILE+PP group, the initially reduced SBP, DBP, RR, and HR scores increased close to the levels observed in the control group. The SBP, DBP, RR, and HR values in the PP group were significantly lower compared to the other groups (p < 0.01). The mortality rate was 100% (with survival duration of 60 min) for the PP group; however, it was 0% for the remaining three groups. Conclusions: Our results suggest that the untoward effects of propofol including hypotension, bradycardia, and respiratory depression might be prevented with ILE therapy.

Highlights

Propofol is a general anesthetic used for induction and maintenance of anesthesia
Our results suggest that the untoward effects of propofol including hypotension, bradycardia, and respiratory depression might be prevented with intravenous lipid emulsion (ILE) therapy
The study by Ebert et al on healthy volunteers compared the effects of propofol and placebo; and significant reductions in the respiratory rate, blood pressure, and pulse rate were reported in the propofol group [4]

Summary

Introduction

Propofol is a general anesthetic used for induction and maintenance of anesthesia. It is commonly used for sedation purposes [1]. There are several studies examining the cardiac depressant effects of propofol in the literature. In one of those studies, the incidence of hypotension (SBP < 90 mmHg) and bradycardia (HR < 50 pulse/min) were developed in 15.7% and 4.8% of the patients respectively after receiving an induction dose propofol. The study by Ebert et al on healthy volunteers compared the effects of propofol and placebo; and significant reductions in the respiratory rate, blood pressure, and pulse rate were reported in the propofol group [4]. We had hypothesized that ILE therapy might be effective in preventing mortality and cardiorespiratory depressant effects due to propofol intoxication. A repeated measures linear mixed-effect model with unstructured covariance was used to compare the groups

Objectives

Methods

Results

Conclusion